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Predictive risk factors for amputation in diabetic fetid foot infections

Abstract number: 1733_964

Barberan J., Sanchez B., Menendez M.A., Toral J.R., Fe A., Fraile I., Alguacil R., Martinez D., Prieto J.

Objective: Lower extremity amputation (LEA) is one of the most disabling complications of diabetes. We report a serie of diabetic foot infections treated with antibiotic therapy and surgery, to examine the association of usual tests in its management with incidence of amputation.

Methods: All enrolled patients had a previously history of diabetes and infection defined by clinical symptoms and signs. Infections were categorised by size and depth. Usual test in management were determined at baseline in all patients.

Results: Seventy eight patients (68.8 ± 2.3 years) were included (55 had vascular insufficiency, 7 neuropathy, and 15 both). Amputation was performed in 26 (33.3%) cases, and it was associated significantly more frequently with previous ulcers (p = 0.001), vascular insufficiency (P = 0.011), size depth of tissue involeved (P = 0.001), Wagner's classification (P = 0.00001), purulent secretions (P = 0.048), and fetid smell (p = 0.033). In a multivariant analysis doppler arterial pressure, Wagner's classification, and ESR (erythrocyte sedimentation rate) were found the best variables to indicate the risk of LEA.

Conclusions: With this logistic model and once known three usual tests, easy to obtain (ESR, doppler arterial and Wagner's classification), we could predict correctly, in about 90% of cases, the survival of lower limb afected. These results suggest that single usual tests the low cost can be very useful to find out the risk of amputation in the diabetic fetid foot.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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